Kowalski J C
Kowalski-Dickow Associates, Inc., Mequon, WI, USA.
Healthc Financ Manage. 1997 Jul;51(7):74-6, 79.
Some providers dealing with the financial challenges of managed care are attempting to control supply expenses through capitated supply contracting and similar risk/reward sharing arrangements. Under such arrangements, a supplier sells products and services to a provider for a fixed, prospective price in exchange for the provider's exclusive business. If expenses exceed the prospectively established amount, the supplier and provider share the loss. Conversely, if expenses are less than the fixed amount, they share the savings. For a capitated supply arrangement to be successful, providers must be able to identify and track supply expense drivers, such as clinical pathways, technology utilization, and product selection and utilization. Sophisticated information systems are needed to capture data, such as total and per-transaction product usage/volume; unit price per item; average and cost per item; average and total cost per transaction; and total cost per outcome. Providers also will need to establish mutually cooperative relationships with the suppliers with whom they contract.
一些应对管理式医疗财务挑战的供应商正试图通过按人头供应合同及类似的风险/回报共享安排来控制供应成本。在这类安排下，供应商以固定的预期价格向供应商销售产品和服务，以换取供应商的独家业务。如果费用超过预期设定的金额，供应商和供应商分担损失。相反，如果费用低于固定金额，他们分享节余。为使按人头供应安排取得成功，供应商必须能够识别和跟踪供应成本驱动因素，如临床路径、技术使用情况以及产品选择和使用情况。需要复杂的信息系统来获取数据，如每次交易的产品使用总量/数量；每件产品的单价；每件产品的平均成本和成本；每次交易的平均成本和总成本；以及每个结果的总成本。供应商还需要与他们签约的供应商建立相互合作的关系。
